Perplexing BG swing....Can't figure it out

Hi Folks,
I just joined about a month ago (or so) and have to say I really enjoy the posts I've been reading and the discussion.
My Zoe has a host of issues which I listed in my introduction post (I don't want to bore you with it again) but now that I've updated her spreadsheet, I'd like to get input from anyone that is or has experienced the same thing. When I created her spreadsheet, I went back to the beginning of Sept but she's had diabetes for a year now, except for the slight remission between Oct-Jan.
Zoe's BG numbers are swinging. The recurring theme is that in the morning she's well within normal ranges and does not get any insulin. Then by the PM testing, she's quite high and needs insulin.
We used to have her on a very tight protocol where, even if she was within normal ranges, she was getting a wee bit of insulin. This was to try to get tight control on her BG when she was in the mid-20's. The protocol worked and with a slight reduction in pred and the protocol, we were able to bring her average numbers down.
We've reduced the pred about as far as we can - she stops eating without it. I can understand pred causing her BG to be raised but it shouldn't cause BG swings.
Lately she's become more and more finicky - I think her nausea from her severe IBD is getting worse and she's not eating well. A few days ago she stopped eating all food but she's liking poached chicken breast for now but I'm sure that will be short lived like everything else is.
Thanks in advance for all opinions and discussion.

 

Hi and good morning Linda. I am not able to address your concerns today, but I wanted to say I remember your introduction post. I think it would be very helpful to others if you would edit your signature to reflect the other issues and medications, so that members know everything you are dealing with (IBD etc.) Granted there is only so much space allowed for the signature information and you may have to condense or eliminate some of the information already there. It would be good to note the insulin dose, what testing meter you are using, and maybe just generally the carb percentage of food she is getting to be able to display some of the other information. Just a thought so that as much pertinent info as possible is available.
Also, since you are a Lantus user, you could post this most recent concern in the Lantus forum. That's where the most experienced Lantus users can see these issues also and can offer some input.

 

Hi Lou....thanks so much for your tips. I've updated my signature to include the meds Zoe is on. I've added a tab to her spreadsheet to provide her insulin protocol. She's on a dosage of insulin that is dependent on her BG readings at any given time. I don't see a carb listing on any of the food she eats so I'm not sure how to determine how many carbs she's eating. I spoke with her vet last Friday who confirmed that the food I'm feeding Zoe has nominal carbs and she's not convinced it's Zoe's diet that is causing her diabetes. We knew that the diabetes was originally caused by the steroid she needs to be on but we can't figure out what is causing the BG swings.

 

If you have time, take a look at the canned food chart here on the board and see if the food Zoe is eating is there. Here is a link to that chart: FOOD
I sure wish you luck figuring out what is going on and how to help get Zoe regulated. Hopefully the more experienced Lantus users will be able to comment.

 

Hi & welcome to the forum. I’m not able to address the bg swings other than to say that some mid-cycle testing is needed to know what her bg is when the Lantus is the most affective. It reaches its peak (nadir) in most cats at the +5-+7 hour. I have a cat with Ibd & pancreatic flairs. She is on budesonide which took her out of a short remission time. But we had to address the Ibd. I give Baby cerenia for nausea & just wondered if you had tried that. Others have mentioned zofran as this also seems to help with the appetite. Good luck with your Zoe & I hope things will calm down for you!

 

Hi Becky....so sorry for the delay in responding. I read your post and wanted to action it and when I came back later to respond and couldn't find it again

It sounds like Zoe has some similar issues as Baby. Zoe was also in remission for a short time but her IBD got worse (with pancreatitis) and those had to be addressed as a priority.

Zoe's been on Cerenia in the pas but it didn't seem to do a lot for her nausea. I'm not even sure it helped with her vomiting when she has a flare up.

I have tried Metonia (Metoclopramide) and it seemed to work. I had her on it for awhile and then stopped because she was just on so many drugs - she was starting to hate pilling time which seemed to be every time I approached her. The Metonia worked really well for her nausea and when your reply triggered my memory, I tried it again. Yesterday I gave her some and within an hour she was eating. I gave her some before bed and she had me up all night like a newborn wanting more food. I'm going to adjust her dosage schedule on that for today haha.

I also took her BG every hour (that I could) yesterday and the results were so weird. I think her AM Lantus shot reached its peak in hour 2 because starting with hour 4 it started to rise. I gave her her first dose of Metonia between hour 6 and 7 and her BG held steady and even went down before going up again. I missed 2 hours in there so don't know if it was a spike or a gradual incline. Could IBD/nausea cause a rise in BG?

I'm going to do it again today and see what happens. Taking her BG often will help, I think, to find some coorelation among all her sympoms (Ihope)

Thanks so much for your reply and triggering my memory.....Zoe is feeling much better (today) because of the Metonia.

Linda.

 

Linda, hi & I’m glad that Zoe had a good appetite!
I guess I do not quite understand the way you decide on the dosing. We test the am & pm to be sure it’s safe to shoot. The amount of insulin is based on regular data collected for the nadir, or mid cycle numbers. The SLGS protocol (what I use) is in the stickies at the top of the Lantus forum. If this is followed.. I would think that Zoe’s blood sugar will be more regulated.
When testing at different times in each cycle, you will find the best dose to keep her safe & feeling so much better. I hope you can read those & apply this process to see if it helps. Good luck!

 

Ohhhhhhhhh, I thought the amount of insulin was based on the pre-shot test!!!! oh boy!
I've been taking Zoe's blood as often as I can during the day and she never does get down to normal or stay there very long. I will go look at the SLGS protocol in the stickies. THANK YOU so much Becky for pointing that out to me.

 

Good deal! I’m so happy to help! Good luck & every bit of knowledge is going to help you both!